Healthcare Provider Details

I. General information

NPI: 1427741958
Provider Name (Legal Business Name): TINA KIEU DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/31/2023
Last Update Date: 08/27/2026
Certification Date: 08/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18040 SW LOWER BOONES FERRY RD STE 304
TIGARD OR
97224-7259
US

IV. Provider business mailing address

18040 SW LOWER BOONES FERRY RD STE 304
TIGARD OR
97224-7259
US

V. Phone/Fax

Practice location:
  • Phone: 503-216-0700
  • Fax:
Mailing address:
  • Phone: 503-216-0700
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberDO231619
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: